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Nursing home operators in New York are pressing hard to win a significant Medicaid rate increase for 2024, while at the same time, state lawmakers are moving closer to adding more oversight funding.

The state’s budget deadline is April 1, and plenty of aging services allocations remain in play. The question is how much support nursing home providers might get as competing interests and consumer concerns appeal for their own funding.

Gov. Kathy Hochul (D) initially requested just a 5% increase for nursing homes, a rate providers said would lead to more bed reductions and worsen access issues for patients statewide.

Stephen Hanse, president and CEO of New York State Health Facilities Association/New York State Center for Assisted Living, told McKnight’s Long-Term Care News Thursday that both the state Senate and Assembly have proposed a 10% increase in their respective budgets.

But that’s still a far cry from the 20% the advocacy group is pushing for.

“For over 15 years, New York has cut Medicaid funding to nursing homes,” Hanse said in an email. “The statewide average daily cost to provide essential care to a Medicaid resident in a nursing home is $265 per resident per day. However, New York’s statewide average daily reimbursement for such care is $211 per resident per day. This $54 shortfall is the largest in the nation.”

Hanse said that $211 works out to only $8.79 per hour, an amount far below the state’s minimum wage.

“The State’s underfunding of Medicaid prevents providers from competing in the labor market for necessary workers and causes significant backups in hospitals as many nursing homes are unable to secure sufficient staff,” Hanse added.

Many of the state’s nursing homes are operating with beds or entire wings offline. Others are consolidating.

But lawmakers haven’t rushed in to offer staffing solutions. 

Instead, in the final two weeks ahead of an April 1 deadline, they seem to be gravitating toward other aging services needs. Among those being promoted by lawmakers is an additional $15 million for an existing ombudsman program to ensure representatives better monitor care of nursing home patients.

“These individuals are often isolated, lonely, they often have mental health issues. They just need someone to show up, knowing that we care,” said Assemblyman Ron Kim (D), who has been an outspoken critic of nursing homes during the pandemic. 

“We need to center the solutions around the families, the workers that are on the ground, that have real time intelligence on the ground,” Kim said earlier this month, according to Spectrum News. “We should be centering our solutions around them, but we haven’t done that.”

In addition to the ombudsman program, Assembly lawmakers are also backing $7.2 million in Department of Health funding for respite care and $2.1 million for care teams to provide aid to low-income adults — efforts that would shore up home care but potentially reduce money available to further adjust Medicaid rates.